I congratulate Tim Farron on securing the debate. His speech reflected his strong feelings on the matter. I also pay tribute to all the national health service staff in Cumbria and Lancashire who have made great progress in improving the local NHS.
Before moving to the hon. Gentleman's specific points, it is worth taking a few moments to reflect on the changes in his constituency in recent years. I am sure that he will join me in acknowledging the significant funding increases to the NHS. In the allocation round that covers 2003-06, Morecambe Bay primary care trust received a cash increase of £76.7 million or 28.7 per cent. Further cash increases of £66.2 million or 17.8 per cent. will follow over the two-year period to 2007-08.
Overall, the Cumbria and Lancashire strategic health authority has seen the benefit of extra funding since 1997, with 180 more consultants, 2,200 more nurses and 1,500 more health care assistants. That translates into, for example, reductions in waiting times. In the SHA, the number of people waiting more than 26 weeks for in-patient treatment has fallen to 16, and no one waits more than 13 weeks for out-patient treatment.
That is genuine progress, which has much to do with the dedication and commitment of local staff. However, alongside record investment, it is important that the health service continues to reform to deliver the NHS that we all want in the 21st century. As part of the programme of modernisation and reform, many NHS organisations are considering, with local stakeholders, changes to the way in which they organise their services. I am sure that the hon. Gentleman agrees that it is important for hospital and community services to adapt if we are to continue to meet patients' needs and improve access to services.
The hon. Gentleman spoke specifically about the future of coronary care at Westmorland general hospital, which is part of the University Hospitals of Morecambe Bay NHS Trust. The trust admits acute surgical patients at Lancaster and Barrow and acute medical patients at all three sites, although more critical patients are transferred from Westmorland to Lancaster for treatment.
The coronary care unit at Kendal has four beds and provides care for patients with acute coronary problems. Last year, it treated 514 patients. Cardiac rehabilitation services are also provided there, as well as in Lancaster and Barrow.
I would not question the hard work of the local staff, but the trust has identified strong clinical and financial reasons why the current pattern of acute medical services—including the cardiac care unit—needs to be reviewed. On the clinical front, the overriding consideration has to be patient safety. Consultant physicians at Westmorland have raised concerns about the admission of acute medical patients to the hospital and their management on several occasions. I realise that the hon. Gentleman questions this, but the Royal College of Physicians has issued guidance on the minimum resources, both human and capital, required to run such a unit. This guidance presents a real challenge to the trust's present pattern of service provision.
On the financial front, the trust ended the last financial year with a £6.3 million deficit, and needs to deliver cost savings of more than £11 million in this financial year. The trust has also identified the fact that it has higher than average costs for its emergency activity, in part due to the additional costs of providing a service over three sites.
These are genuine and pressing challenges for the trust, and it needs to take a rigorous look at how it provides its services. That is quite the right approach to take. Together with Morecambe Bay PCT, the trust has reviewed the provision of its acute medical services across all three sites. The review aimed to improve the management of patient flows, the patient journey, operational management and bed usage, and was conducted in the context of national best practice and policy requirements.
The hon. Gentleman will be aware that the pre-consultation stage of the review has recently ended. That stage explained the background to the service review and gathered the views of the public, external stakeholders and staff. A hospital services review steering group, chaired by the trust's medical director, has assessed responses to the exercise. Four models for acute medical services have been identified and the public consultation document on the acute medical review will be published tomorrow. The formal consultation on the four models will run until
I am aware that the hon. Gentleman's concern centres on the future of acute services at Westmorland general hospital, and especially on the coronary care unit. Under the four options identified following the service review, the number of medical beds at Westmorland could be as few as zero or as many as 50. The hon. Gentleman will also be aware that one of the options includes the retention of the coronary care unit at Westmorland general hospital.
The hon. Gentleman raised the issue of the possible closure of the laboratory. As I understand it, even if the coronary care unit were to close, the laboratory would not necessarily close. The review is looking into the overall provision of laboratory services in the area. He also described very graphically the impact that the possible closure of the coronary care unit in Kendal might have on the local ambulance service. I hope that I can assure him that the ambulance service is part of the acute service review steering group, and that the potential impact on the ambulance service of any changes to service provision, including to the coronary care unit, will be thoroughly explored.
It is important to stress that at this stage no decisions have been made on the service redesign, and none will be made until the outcomes of the formal consultation are known. Following the end of the consultation period, the local NHS is responsible for reaching a decision on how to proceed. The final decision will be considered by the local authority's health overview and scrutiny committee, which has the right to refer any decision to the Secretary of State for Health if it contests a substantial change in health services on grounds of inadequate consultation or the merits of the proposal. I hope the hon. Gentleman will appreciate that as there is a possibility that the matter may ultimately be referred to the Secretary of State, it is not appropriate for me to comment on the proposals for future configuration of acute medical services provided by the trust.
The hon. Gentleman said that the strategic health authority had a £33 million surplus. That is not correct. It was an estimate of the financial position, but following a redistribution of resources, the money is no longer available.
The hon. Gentleman also commented on the way in which allocations are made to primary care trusts and, in particular, to rural areas. Funds are allocated to PCTs on the basis of the relative needs of their populations. A weighted capitation formula is used to determine each PCT's share of the available resources to allow the commissioning of similar levels of health services for populations with similar needs. The components of the formula are used to weight each PCT's crude population according to the relative need for health care, and in the light of unavoidable geographical differences in the cost of providing health care.
The Advisory Committee on Resource Allocation has considered the rurality issue on a number of occasions. As a result, the allocation formula used in 2003-04 and in the 2006-08 allocations provides the best available measure of health need in all areas. In calculating heath need in rural areas, it takes account of the effects of access, transport and poverty.
Let me end by congratulating the hon. Gentleman again, but also by encouraging him to continue to discuss what is best for services with the local NHS. I am sure that he and his constituents will make their views on the final proposals known through the consultation exercise. It is important that we have consultation procedures that are reviewed and managed properly, but there are local avenues as well.
Question put and agreed to.
Adjourned accordingly at twenty-seven minutes to Eleven o'clock.